AI-Driven Diagnostic Tool Reduces Sepsis Deaths by 20% at Louisiana Hospital

The new diagnostic test determines the level of activation of a patient's immune system, which reflects whether the patient has sepsis.

A Baton Rouge, Louisiana-based hospital has generated positive results such as reduced cost of care from using a new artificial intelligence-driven early diagnosis tool for sepsis.

Sepsis is the body's extreme reaction to an infection that can result in tissue damage and organ failure. Annually in the United States, there are at least 1.7 million adult hospitalizations for sepsis and at least 350,000 deaths from the condition, according to the Centers for Disease Control and Prevention.

Our Lady of the Lake Regional Medical Center, which is part of Baton Rouge, Louisiana-based Franciscan Missionaries of Our Lady Health System, has adopted IntelliSep, an AI-driven sepsis diagnostic testing system developed by San Francisco-based Cytovale Inc. IntelliSep gained Food and Drug Administration approval in January 2023.

IntelliSep determines the presence or absence of sepsis by measuring the activation of a patient's immune system, says Catherine O'Neal, MD, CMO at Our Lady of the Lake Regional Medical Center.

"As a patient approaches severe sepsis and septic shock, the immune system is more activated," she says. "IntelliSep measures the range of activation from a patient who is not activated at all to a patient who has a highly activated immune system against an infection. Highly activated patients tend to be more likely to have septic shock."

IntelliSep is one of several AI-driven sepsis diagnostic tools that have been developed in recent years. Other AI-driven sepsis diagnostic tools include the following:

• Steripath, which decreases blood culture contamination to increase sepsis testing accuracy
   
• Sepsis Immunoscore, which is an AI and machine learning software that is designed for rapid diagnosis and prediction of sepsis
   
• Targeted Real-Time Early Warning System, which is an algorithm developed at Johns Hopkins Medicine that is integrated into electronic health records and is designed for early recognition of sepsis

Benefits of using IntelliSep

Our Lady of the Lake Regional Medical Center has generated several benefits from using IntelliSep.

The sepsis diagnostic test has improved efficiency in the emergency department, O'Neal says.

"It is getting patients through the emergency department more efficiently," she says. "You want your testing to pinpoint what is wrong with a patient as quickly and accurately as possible. The test can tell us within 10 minutes whether the patient is seriously ill from an infection or the patient is not infected at all and not seriously ill. By pinpointing who needs care faster, we can be more efficient with the rest of our testing and get patients through the ED faster."

IntelliSep has decreased the number of blood cultures taken at the hospital, says Christopher Thomas, MD, vice president and chief quality officer at Franciscan Missionaries of Our Lady Health System.

"Because we are concerned about sepsis and its high mortality in the United States, the Centers for Medicare & Medicaid Services tells us that every patient with a suspected infection must get blood cultures," he says. "If you don't know who is going to get sick, and you can't tell the difference between a patient with an activated immune system and a patient who does not have an activated immune system, then they all should get blood cultures."

Over the eight months that Our Lady of the Lake Regional Medical Center has used IntelliSep, the hospital has spared 1,800 patients from getting blood cultures, Thomas says.

"That's a big deal because it is a procedure," he says. "Not getting a blood culture is a big deal to me. It takes about eight minutes to collect each blood culture and you must do it perfectly. About 2% of the time, a blood culture comes back positive for an infection because of bacteria on the skin."

IntelliSep has reduced cost of care, Thomas says.

"We know from a study that we are saving patients who receive the IntelliSep test an average of $1,400," he says. "That comes from not having to prescribe an expensive antibiotic. That comes from avoiding blood cultures. That comes from patients spending less time in the hospital."

A recent study published in Academic Emergency Medicine found that IntelliSep correctly identified which patients did not have sepsis 98% of the time, making it an essential tool for clinicians to rule out sepsis and explore alternative diagnoses.

The accuracy of the test has been a boon at Our Lady of the Lake Regional Medical Center, O'Neal says. The impact of IntelliSep is similar to an electrocardiogram, she says, noting an electrocardiogram can tell a clinician whether a patient is having a heart attack or just has chest pain from another source such as indigestion.

"IntelliSep generates similar benefits," O'Neal says. "A patient may have an abscess, but IntelliSep can tell us whether we have time to observe the patient or let the patient go home. If IntelliSep indicates that a patient has sepsis and we identify it early, we can save lives through early intervention. We now have a tool that tells us who needs intervention quickly, just like the electrocardiogram tells us whether a patient is having a heart attack and needs care immediately."

Generating results

Data shows that IntelliSep has had a positive impact on patients and operations at Our Lady of the Lake Regional Medical Center, Thomas says.

• The hospital conducted 1,800 less blood cultures in six months than the facility did in a six-month span a year ago
• Since adopting IntelliSep, the hospital has saved nine days of nurse staffing time
• Length of stay for sepsis patients in the ICU has been reduced by two days
• Since adopting IntelliSep, the hospital has reduced sepsis mortality by 20%

"From the quality-of-care standpoint, we have never seen this kind of reduction in mortality at our hospital," O'Neal says. "It is hard to move the needle on saving lives."